SGN2002-00039 CITY OF TIGARD SIGN PERMIT
I , DEVELOPMENT SERVICES PERMIT #: SGN2002 -00039
-- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 3/20/2002
EXPIRATION DATE:
BUSINESS NAME: SOURCE ONE NETWORK INC.
SIGN LOCATION: 11700 SW 67TH AVE PARCEL: 1 S136DD 0400
APPLICANT /AGENT: SOURCE ONE NETWORK INC. ZONE: MUE
BUSINESS TAX NO: JURISDICTION: TIG
SIGN
PERMANENT: X FREESTANDING: Y FREEWAY:
TEMPORARY: WALL: ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 3' X 3' X 1'
TOTAL SIGN AREA: 9 sq. ft.
WALL AREA: sq. ft.
WALL FACE (DIRECTION):
SIGN HEIGHT: 3 ft.
PROJECTION FROM WALL: in.
ILLUMINATION: NON
DESCRIPTION OF SIGN: Permanent placement of (1) non - illuminated freestanding sign. Not to be placed in
visual clearance area if over 3' or in public right of way.
MATERIALS: ALUM
EXISTING SIGNS: 1
ELECTRICAL PERMIT REQUIRED: N
BUILDING PERMIT REQUIRED: N
ADMINISTRATIVE EXCEPTIONS:
TOTAL PERMIT FEES: $ 50.00
This permit is issued subject tothe- regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all other applicable laws.All work will be done in acca ance with approved plans. A sign permit shall expire 90
days from approval date. A7temporary sign shall expire 30 ays f om approval date. A balloon sign shall expire 10
L /
Hays from annrnval riata
APPROVED B
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PERMITTEE SIGNATURE:
DATE: 3/20/2002
„1� SIGN PERMIT APPLICATION
CITY OF TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 FAX: (503) 684 -7297
GENERAL INFORMATION
Name of Development/Project
Site � ^ �, • /
C � 'n
� NI 11L1 UVI V__ TAN. FOR STAFF USE ONLY
Address/ Street Address
Permit No.: •L' . L--‘ - ' , 1.-- C��U0�
Location Il E)Lk) L1” kve. l.i
Suite /Bldg. # City /State Zip Expiration Date:
( LY_ l D_ a 112) Receipt #: a--E`7 ' 10 0
Name Approved By: ��
Pro ?lit I Lev Ac. , G,Q61a Date: 2_-CD l 0 'a- (4-00C)
Owner Mailing Address /� Suite Map/TL #: 1, � ( b
(Q c "
(1`10O [a1 Ne. Zoning: r t WE
City / Zip Phone
/� VEID '"' Za gi1223 `jn alf- IDOL Electrical Permit Required? ❑ Yes o
Name ((��,�� �n �,p�
Business S�U,A11- F '\ I L 11YIL [ , Building Permit Required? ❑ Yes o
Name Rev. 30 -Jul -01 i.\curpin \masters \revised\sign permit app.doc
Sign
Contractor Mailing Address . Suite REQUIRED SUBMITTAL ELEMENTS
(Prior to permit (Note: applications will not be accepted
issuance, a
copy of all City /State Zip Phone witho the required submittal elements)
licenses are
required if Completed Application Form
expired in the Oregon Const. Cont. Board Exp. Date
City of Tigard's License # a 2 Copies of Site /Plot Plan, Drawn to Scale
database)
(3 copies, if a building permit is required)
Proposed Q Permanent ❑ Freestanding ❑ Freeway size requirement: 81/2" x 11 ", or 11" x 17"
--t
I
Sign L_1 Temporary ❑ Wall ❑ Electronic ❑ 2 copies of elevations, drawn to scale
(Check all that ❑ Other El Billboard ❑ Balloon (3 copies, if a building permit is required)
apply) size requirement: 8' /2" x 11 ", to 24" x 36"
❑ New sign? ❑ Alter to existing sign?
❑ $50.00 Fee (Permanent sign, any size)
Sign Dimensions: I I
3 x3 X ■ ❑ $15.00 Fee (Temporary sign, any type)
Total Sign Area (sq. ft.): ci I
"I NOTES:
Sign Data Total Wall Area (sq. ft.) • Wall signs do not need to be drawn to scale,
but must include dimensions of wall face and
(Complete all Direction Wall Faces (circle one): sign placement.
items in this
section) N S E W NE NW SE SW • Wall signs do not require site /plot plans.
• Freestanding signs over 6 ft. required a
Height to top of sign (feet): building permit.
Projection From Wall (inches): • If work authorized under a sign permit has not
Copy: been completed within ninety (90) days after
Materials: the issuance of the permit, THE PERMIT WILL
Will sign have illumination? El Yes (A No BECOME NULL AND VOID.
Type: ❑ Internal) External \
Are there any existing freestanding or wall signs at this Not all jurisdictions accept credit cards, please call jurisdiction for more information.
location, including wall signs that overlap a tenant space? visa ❑MasterCard
Credit card number / /
❑ Yes No Expires
If "yes ", a list or diagram of all sign dimensions and Name of cardholder as shown on credit card
square footage must also be submitted. $
Cardholder signature Amount
(OVER FOR SIGNATURES)
I hereby acknowledge that I have read this application, that the information given is
correct, that I am the owner or authorized agent of the owner, and that plans submitted are
in compliance with the City of Tigard.
DATED this 2e day of Me , 20 v Z---
Signature of Owner /Agent
PWI It,p Good (72-t4 - 2-
Contact Person Name Phone No.
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Receipt #: 27200200000000001020
__...'... Date: 03 /20/2002
T I D E M A R K
COMPUTER SYSTEMS, INC.
Line Items:
Case No Tran Code Description Revenue Account No. Amount Due
SGN2002 -00039 [SIGN] Sign Permit 100 - 0000 - 437000 $50.00
Payments:
Method Payer Bank No Acct Check No Confirm No. Amount Paid
Check SOURCE ONE NETWORK INC. 0 381 0 $50.00
TOTAL AMOUNT PAID: $50.00